心脏磁共振成像对心功能不全患者左心室功能的评价价值分析

摘要

目的：分析心脏磁共振成像（CMRI）对心功能不全患者左心室功能的评价价值。方法选取四川大学华西医院放射科2014年1月—2015年6月收治的心功能不全患者44例，均行超声心动图、CMRI 检查，并采用心脏自动分析仪记录左心室每节段心肌厚度。观察不同疾病类型患者心脏形态及运动特点，比较超声心动图和 CMRI 检查结果，包括左心室射血分数（LVEF）、左心室舒张末期容积（LVEDV）、左心室收缩末期容积（LVESV）、每搏输出量（SV）、心排血量（CO）及左心室质量（LVM），同时比较两种检查方法对 LVEF 异常的检出情况。结果 CMRI 检查结果显示，扩张型心肌病患者左心室腔增大，心室心肌壁层厚度变薄且运动减弱；肥厚型心肌病患者左心房腔增大，室间隔和左心室心肌壁层厚度增加，左心室流出道变窄，左心室心肌壁层运动减弱；狭窄性心包炎患者左心房腔增大，两个心室腔变小，室间隔呈“S”型摆动，部分心包增厚，心室心肌壁层运动减弱；冠心病患者心肌和心室壁均无明显变化。两种检查方法 LVEF、LVEDV、LVESV、SV、CO 及 LVM 检测结果比较，差异无统计学意义（ P ﹥0.05）；CMRI 对 LVEF 异常的检出率高于超声心动图（P ﹤0.05）。结论 CMRI 对心功能不全患者左心室功能的评价价值较高，可直观、清晰地观察左心室心肌和心室壁变化，有利于提高 LVEF 异常检出率。%Objective To analyze the evaluation value of cardiac magnetic resonance imaging( CMRI) on left ventricular function of patients with ventricular dysfunction. Methods From January 2014 to June 2015,a total of 44 patients with ventricular dysfunction were selected in the Department of Radiology,Huaxi Hospital of Sichuan University,all of them received examinations of ultrasonic cardiogram and CMRI,and the left ventricular segmental thickness was recorded by cardiac automatic analysis. Heart structure and ventricular wall motion characteristics were observed,examination results between CMRI and ultrasonic cardiogram were compared,including LVEF,LVEDV,LVESV,SV,CO and LVM;detection rate of abnormal LVEF was compared,too. Results CMRI examination results showed that,left ventricular cavity of patients with dilated cardiomyopathy enlarged,the ventricular myocardial wall layer thickness thinned with the motility weakened;left atrial cavity of patients with hypertrophic cardiomyopathy enlarged,the myocardial wall thickness of interventricular septum and left ventricle thickened,the left ventricular outflow tract became narrower,the motility of left ventricular myocardial wall layer weakened;left atrial cavity of patients with constricative pericarditis enlarged,the bilateral ventricular cavity lessened,the interventricular septum swang like " S",partial pericardium thickened,the motility of ventricular myocardial wall layer weakened;while no obvious change of myocardium or ventricular wall of patients with coronary heart disease was found. No statistically significant differences of LVEF,LVEDV,LVESV,SV,CO or LVM was found between CMRI and ultrasonic cardiogram examination results(P ﹥ 0. 05),while detection rate of abnormal LVEF of CMRI was statistically significantly higher than that of ultrasonic cardiogram(P ﹤ 0. 05). Conclusion CMRI has relatively high evaluation value on left ventricular function of patients with ventricular dysfunction,can intuitively and clearly observe the change of left ventricular myocardium and ventricular wall,is helpful to improve the detection rate of abnormal LVEF.